Healthcare News & Insights

Study: Treatment had 94% cure rate in treating clostridium difficile

Running a hospital, you’re very familiar with the fact that over the past few year, Clostridium difficile (C. diff) infections have become more frequent, more severe and more difficult to treat. That’s a big problem for hospitals since tens of thousands of people in the United States get sick from C. diff each year, and it most commonly affects older adults in hospitals and nursing homes. 

So what if there was a treatment for C. diff infections that’s 94% effective? Bet you’d want to offer it at your facility.

But what if it involved feces? Still interested?

A new study found that infusing feces from a healthy person into a patient with a C. diff infection was significantly more effective than traditional antibiotic treatments. The treatment was so successful that the research trial was ended early so patients in the control group could get the treatment, too.

Fecal transplant

The study,  published online by the New England Journal of Medicine, was conducted in the Netherlands and is the first randomized clinical trial to demonstrate fecal transplants can work without causing serious adverse effects.

The researchers treated 43 patients with C. diff infections, and broke them down into three groups:

  • Group 1 was treated only with vancomycin
  • Group 2 was given vancomycin and a bowel lavage/cleansing, and
  • Group 3 was given vancomycin, a bowel lavage and a fecal transplant.

A fecal transplant is done by combining freshly excreted stool from a healthy person with a pint of lightly salted water. The mixture is stirred, strained and administered through a nasal tube that goes down to the first section of the small intestine. By delivering the mixture here, patients don’t taste or smell it. However, transplants also can be delivered rectally with an enema or colonoscope.

Study results

Thirteen out of the 16 patients who got the transplant were cured after just one infusion. Of the three who were still sick, two were cured after receiving a second infusion. That’s a 94% cure rate.

The other groups didn’t fare as well. Of the patients who received vancomycin only, 31% were cured. And of the group that got the vancomycin and the lavage, 23% were cured.

As to adverse events: Immediately after the infusion, 94% of patients had diarrhea, 31% had cramping and 19% had belching. However, in all patients these symptoms went away within three hours.

Treatment theory

Scientists believe the transplants work by restoring microbial diversity in a sick gut.

“Feces from a healthy donor contain a rich and complex assortment of organisms that have developed beneficial, symbiotic relationships with humans over millions of years of evolution,” Dr. Lawrence Brandt, a gastroenterologist at the Albert Einstein College of Medicine in New York who has conducted transplants for 14 years but wasn’t involved in the study, explained in a Los Angeles Times report. “These gut bacteria influence our metabolic rate, immune system performance, muscular function and even our mood.”

C. diff, on the other hand, upsets the balance of these organisms in the gut. As the C. diff bacteria grows out of control, they release toxins that attack the lining of the intestines, causing diarrhea, abdominal pain, loss of appetite, fever, blood or pus in the stool and weight loss. And all of these can be very dangerous for a patient who is already sick in the hospital.

PR issue

While there are physicians in the U.S. doing fecal transplants, it has been slow to catch on. Plus the treatment does have a bit of a public relations problem.

“I hope this [the study] will help to change minds,” Dr. Colleen Kelly, a gastroenterologist at Brown University‘s Alpert Medical School in Providence, R.I. Kelly, who was not part of the Dutch research team, told the Los Angeles Times. “Those of us who do them know they’re effective, and to our patients, it’s like a miracle.”

 

 

Subscribe Today

Get the latest and greatest healthcare news and insights delivered to your inbox.

Comments

  1. Very interesting!

Speak Your Mind

*

css.php